title: Utility of the ISTH bleeding assessment tool in predicting platelet defects in participants with suspected inherited platelet function disorders.
abstract: BACKGROUND
  The ISTH bleeding assessment tool (ISTH-BAT) was developed to record bleeding symptoms and to aid diagnosis in patients with a possible bleeding disorder.
  
  
  OBJECTIVE
  To investigate the utility of the ISTH-BAT in predicting functional defects in platelet activation in participants with suspected inherited platelet function disorders.
  
  
  METHODS
  Participants with clinical evidence of excessive bleeding and suspected inherited platelet function disorders and healthy volunteers were recruited to the Genotyping and Phenotyping of Platelets study (GAPP; ISRCTN 77951167). The ISTH-BAT questionnaire was applied by a trained investigator prior to lumiaggregometry.
  
  
  RESULTS
  One hundred participants were included (79 with suspected inherited platelet function disorders, and 21 healthy volunteers). The ISTH-BAT score in participants with suspected inherited platelet function disorders (median 12; interquartile range [IQR] 8-16) was significantly higher than in healthy volunteers (median 0; IQR 0-0). There was no difference between participants with suspected inherited platelet function disorders with a platelet defect detected by lumiaggregometry (median 11; IQR 8-16) and those with normal platelet function (median 12; IQR 8-14) (P > 0.05). The ISTH-BAT score was not associated with a demonstrable platelet defect on platelet function testing (area under the receiver operating characteristic curve = 0.501 [95% confidence interval 0.372-0.630, P = 0.98] and odds ratio 1.01 [95% confidence interval 0.93-1.09, P = 0.91]).
  
  
  CONCLUSIONS
  The ISTH-BAT is a powerful tool for documenting lifelong bleeding history. However, the score obtained is not predictive of the presence of a platelet defect on lumiaggregometry in patients with suspected inherited platelet function disorders.
authors.affiliation: Centre for Cardiovascular Sciences, Institute of Biomedical Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: G C
authors.initials: GC
authors.lastname: Lowe
authors.forename: M
authors.initials: M
authors.lastname: Lordkipanidzé
authors.forename: S P
authors.initials: SP
authors.lastname: Watson
mesh_terms: D001791:Blood Platelet Disorders / Q000150:complications / Q000175:diagnosis*; D016022:Case-Control Studies; D006470:Hemorrhage / Q000150:complications*; D006801:Humans
keywords: Blood platelet disorders; Coagulation disorders, inherited; Decision support techniques; Platelet aggregation; Platelet function tests